The impact of demographic and clinical characteristics on diabetic painful neuropathy.

INTRODUCTION: Diabetic neuropathy (DN) is one of the most devastating complications of diabetes mellitus; however, in contrast to other countries, there are no scientific studies in Portugal evaluating the impact of demographic and clinical characteristics of this pathological entity. The aim of this study was to evaluate the impact of gender, metabolic control, age of diabetic patients, as well as time of disease progression, the appearance of complaints related to neuropathic pain. MATERIAL AND METHODS: A multicentre study with a non-probabilistic, convenience sample of 359 patients was performed employing the quantitative method, using the Statistical Package for Social Science 24 software. The p-value of p < 0.05 was defined to consider a result statistically significant. The Spearman correlation coefficient (r) was determined to determine the relationship between categorical variables. RESULTS: There was no statistically significant difference in the prevalence of DN between genders (p = 0.633 and r = 0.025). There was a statistically significant relationship between the value of HbA1c and DN, with p = 0.010 and r = 0.136. There is a relationship between age and complaints of neuropathic pain, with p = 0.034 and r = 0.112. The variable, time of disease progression, is also correlated with the appearance of complaints of neuropathic pain with p = 0.020 and r = 0.112. CONCLUSION: The prevalence of neuropathic pain in subjects with diabetes is not negligible and is associated with modifiable risk factors that can be identified, possibly modified and prevented. The correct approach for these patients, which involves screening and early treatment, is decisive improving functionality and quality of life.

Association between Asthma and Primary Nocturnal Enuresis in Children.

PURPOSE: Enuresis, sleep respiratory disorders and asthma compromise the quality of sleep in children and may occur in association with each other. An association between sleep respiratory disorders and enuresis has already been demonstrated. According to united airways disease abnormalities of the upper and lower airways may coexist. A child who wheezes has a greater chance of snoring and having obstructive sleep apnea. Since asthma and sleep respiratory disorders may be associated, and sleep respiratory disorders are associated with enuresis, we determined the possibility of an association between asthma and enuresis. MATERIALS AND METHODS: Between August 20 and March 2015 parents/guardians of children 6 to 14 years old from 16 elementary schools in our area were randomly chosen for study. Children with nonmonosymptomatic enuresis and urological or neurological disease were excluded. The Tucson and ISAAC (International Study of Asthma and Allergies in Childhood) questionnaires were used to assess sleep respiratory disorders and asthma, respectively. RESULTS: A total of 523 children (283 males and 240 females) with a mean ± SD age of 9.42 ± 2.46 years were included in analysis. The overall prevalence of enuresis was 15.87% (95% CI 12.98-19.26). Asthmatic children with wheezing in the last 12 months were 2.33 times more likely to have had enuresis at some point in life (OR 2.33, 95% CI 1.37-3.95, p = 0.0017). If enuresis was present, the chance increased to 2.78 (95% CI 1.38-5.61, p = 0.0041). Enuretic children were 5.34 times more prone to have apnea reported by parents (95% CI 2.19-13.03, p = 0.0002). CONCLUSIONS: These findings demonstrate that asthma as well as sleep respiratory disorders is associated with primary nocturnal enuresis.

Contribuições dos estudos de percepção de risco para a análise e o gerenciamento de exposições humanas aagrotóxicos: o caso de Lucas do Rio Verde, MT / Contributions of studies of risk perception for the analysis and management of human exposures to pesticides: the case of Lucas do Rio Verde, MT

Os estudos de Percepção de Risco surgem entre as décadas de 1970 e 1980, visando aomelhor entendimento sobre as motivações que determinam diferentes indivíduos egrupos a reagirem ante um determinado perigo. O principal ponto de partida dessesestudos é conhecer no que diferem as respostas de especialistas e não especialistas(“leigos”) diante de um mesmo problema. Tanto no meio rural quanto no meio urbano,os estudos de percepção de riscos são notadamente importantes por caracterizarsituações que outros tipos de estudo (epidemiológicos, toxicológicos, avaliações derisco) não são capazes de demonstrar. Assim, esta Tese de Doutorado objetivacompreender a importância dos estudos de percepção de riscos para a análise dasexposições humanas a agrotóxicos, a partir de um estudo de caso realizado nomunicípio de Lucas do Rio Verde, MT, importante polo agrícola de produção de soja.Com base nos resultados desse estudo exploratório, buscou-se analisar, de forma crítica,os determinantes da percepção de riscos associados à exposição humana a agrotóxicos,devidamente contextualizados por experiências registradas na literatura de referência. Apartir dos resultados desse estudo procurou-se consolidar a necessidade deincorporarmos os estudos de percepção de riscos, de forma sistemática, à lógica deatenção e vigilância de populações vulneráveis em face do intenso uso de agrotóxicosnos diversos processos de produção agrícola do país, bem como às iniciativas deavaliação e gerenciamento de riscos que tenham nesse tema seu foco...

Risk Perception studies arise between the 1970s and 1980s aiming to understand majormotivations that determine different individuals and groups to act when facing aparticular hazard. The main starting point of these studies is to understand the differingresponses of experts and non-experts ("lay people") facing the same problem. Both inrural and urban areas, risk perception studies are especially important to evincesituations that other types of studies (epidemiological, toxicological, risk assessments)are not able to demonstrate. This DSc. Dissertation aims to understand the importanceof risk perception studies for the analysis of human exposures to pesticides, using asbaseline data from a case study in Lucas do Rio Verde municipality, Mato Grosso State,Central Brazil, an important agricultural region for soybean production. Based on theresults of this exploratory study, we sought to examine, critically, the determinants ofrisk perception associated with human exposure to pesticides, contextualized throughexperiences registered in the reference literature. The results of this study showed theimportance of incorporating risk perception studies, systematically, into health care andhealth surveillance of vulnerable populations living in areas of intensive pesticides usein agriculture, as well as in the scope of risk assessment and management initiativesfocusing on this issue...

Design of risk communication strategies based on risk perception among farmers exposed to pesticides in Rio de Janeiro State, Brazil.

BACKGROUND: This study aims to assess pesticide exposure risk perception among farmers from three rural areas of Nova Friburgo, Rio de Janeiro State, Brazil. METHODS: Data were collected through semi-structured interviews with 66 adults and participatory workshops with 27 teenagers and analyzed through content analysis techniques. Systematized results were discussed at local meetings, and two risk communication initiatives were devised. RESULTS: Study results demonstrated the use of defensive strategies by men and a diminished risk perception among women. Teenagers relied on parents to develop their own work practices. These findings supported the importance of cultural and social determinants of farmers' understandings of risk and of the relevance of different pesticide exposure pathways. CONCLUSIONS: Risk perceptions and work practices are strongly influenced by local cultural patterns and, therefore, must be taken into account when developing effective intervention strategies, including risk communication initiatives.

Análise qualitativa de méis silvestres produzidos e comercializados no Estado do Rio de Janeiro / Qualitative analysis of wild honeys produced and commercialized in the State of Rio de Janeiro

A garantia da qualidade do mel reveste-se de grande importância para consumidores, produtores e, notadamente, órgãos reguladores. Frequentemente, o mel tem sido alvo de fraudes e adulterações por parte de produtores e comerciantes desonestos. Os estudos relacionados à qualidade do mel recomendam a determinação de parâmetros físico-químicos que podem revelar adulterações. No presente trabalho foram avaliados os teores de 5-hidroximetilfurfural (HMF) e a atividade diastásica. Na pesquisa de enzimas diastásicas realizadas, 11 amostras (44%) apresentaram resultados negativos. Portanto, um percentual significativo das amostras produzidas e comercializadas no estado do Rio de Janeiro não se encontra dentro dos padrões preconizados pela legislação brasileira.

Uso de agrotóxicos na produção de soja do estado do Mato Grosso: um estudo preliminar de riscos ocupacionais e ambientais / Pesticide use in soybean production in Mato Grosso state, Brazil: a preliminary occupational and environmental risk characterization

OBJETIVO: identificar e discutir alguns dos principais riscos associados ao uso de agrotóxicos na produção de soja do estado de Mato Grosso. MÉTODO: estudo exploratório descritivo, de caráter preliminar, realizado entre 2008 e 2009 e baseado em triangulação metodológica que incluiu: análise de banco de dados agrícola; análise de indicadores biológicos da exposição a agrotóxicos; e análise da contaminação de água de chuva por esses agentes químicos. RESULTADOS: a análise dos dados de consumo mostra um elevado e crescente uso de agrotóxicos, em particular o do herbicida glifosato. A análise da água de chuva mostrou presença de resíduos de diferentes agrotóxicos, ampliando o risco para além do ambiente de trabalho. Essa exposição ambiental foi detectada pela análise de indicadores biológicos de exposição a agrotóxicos junto a trabalhadores e moradores de áreas próximas às zonas de plantio. CONCLUSÃO: os dados do estudo apontam para a necessidade de um monitoramento ambiental e de saúde permanente em áreas produtoras de soja como parte das estratégias de vigilância em saúde do trabalhador e ambiental.

OBJECTIVE: To identify and to discuss some of the major risks associated to pesticide use in the soybean production in Mato Grosso State, Midwestern Brazil. METHOD: It is a descriptive exploratory pilot-study that was carried out between 2008 and 2009, using methodological triangulation, comprising the following: analysis of an agricultural database, analysis of biological indicators of pesticide exposure, and analysis of rainwater contamination by these chemicals. RESULTS: Analysis of pesticides consumption data showed a high and growing use of pesticides in soybean production, particularly glyphosate. Rainwater analysis evidenced the occurrence of different pesticide residues, indicating the amplification of the risks beyond workplace. This environmental exposure was also detected by biological indicator analysis among workers and residents of the plantation neighboring areas. CONCLUSION: The study data indicate the need for permanent environmental and human health monitoring in soybean production areas as part of workers' health and environmental surveillance strategies.

[The interface of public healthcare with the health of the oceans: proliferation of disease, socio-economic impacts and beneficial relationships]. / A interface da saúde pública com a saúde dos oceanos: produção de doenças, impactos socioeconômicos e relações benéficas.

Over the past decades, human activities have had a heavy impact on the marine environment, causing alterations in ecological processes. The relationship between the health of the oceans, human activities and public healthcare is already generally accepted, though the mechanisms involved are still under scientific scrutiny. These relationships include a focus on climate change, toxic algal blooms, microbial and chemical contamination in marine waters and bioinvasion by exotic species. Moreover, there is the beneficial effect of the oceans on human health and wellbeing, such as natural products for the human diet, the development of biomedicine, or simply the satisfaction derived from human recreation, sports and other interactions of humans with oceans. The importance of appreciating the link between public healthcare and the health of the oceans is especially important due to the growing number of people living in coastal areas, mainly in tropical and subtropical regions. The backcloth to this is risk-related human activities that pose a danger to marine environmental health and the increase in the vulnerability of humans and biodiversity and socio-environmental iniquity.

A interface da saúde pública com a saúde dos oceanos: produção de doenças, impactos socioeconômicos e relações benéficas / The interface of public healthcare with the health of the oceans: proliferation of disease, socio-economic impacts and beneficial relationships

Nas últimas décadas, as atividades humanas têm causado forte impacto sobre o ambiente marinho, provocando alterações no seu processo ecológico. A relação entre a saúde dos oceanos, as atividades antropogênicas e a saúde pública já é consenso, entretanto, seus mecanismos ainda estão sob os olhares da ciência. Essas relações incluem o foco sobre as mudanças climáticas, florações de algas tóxicas, contaminação microbiológica e química nas águas marinhas e bioinvasão de espécies exóticas. Além disso, existe a relação dos valores benéficos que os oceanos proporcionam à saúde e bem-estar da humanidade, tais como produtos naturais relevantes para a alimentação humana, o desenvolvimento da biomedicina, ou simplesmente, a satisfação humana derivada da recreação, esportes e outras interações dos seres humanos com os oceanos. A importância de se conhecer a relação entre saúde pública e a saúde dos oceanos dá-se, principalmente, devido ao crescente número de pessoas vivendo em zonas costeiras, nas regiões tropicais e subtropicais, tendo como pano de fundo as atividades antropogênicas produtoras de risco para a saúde do ambiente marinho, aumento da vulnerabilidade do homem, da biodiversidade e da iniquidade socioambiental.

Over the past decades, human activities have had a heavy impact on the marine environment, causing alterations in ecological processes. The relationship between the health of the oceans, human activities and public healthcare is already generally accepted, though the mechanisms involved are still under scientific scrutiny. These relationships include a focus on climate change, toxic algal blooms, microbial and chemical contamination in marine waters and bioinvasion by exotic species. Moreover, there is the beneficial effect of the oceans on human health and wellbeing, such as natural products for the human diet, the development of biomedicine, or simply the satisfaction derived from human recreation, sports and other interactions of humans with oceans. The importance of appreciating the link between public healthcare and the health of the oceans is especially important due to the growing number of people living in coastal areas, mainly in tropical and subtropical regions. The backcloth to this is risk-related human activities that pose a danger to marine environmental health and the increase in the vulnerability of humans and biodiversity and socio-environmental iniquity.

Comunicação de riscos relacionada a agrotóxicos no Pólo floricultor de Nova Friburgo, RJ / Risk communication related to pesticides in the Hub florist Nova Friburgo, RJ

O uso intensivo de agrotóxicos nas lavouras desacompanhado de políticas normativas e de controle resulta numa série de impactos sobre a saúde humana e sobre o meio ambiente. As intoxicações sofridas pelos trabalhadores rurais podem estar atreladas a vários fatores como, por exemplo, a dificuldade de compreensão das informações sobre os agrotóxicos. Uma solução seria uma assistência técnica mais eficaz e dissociada das casas comerciais, fato cada vez mais presente, acarretando o aumento no consumo desses produtos. Em alguns casos, o acesso às informações fica restrito somente à leitura de bulas e rótulos dos produtos utilizados, sendo a única fonte de comunicação de riscos existente. É um dado preocupante, já que é reconhecido o baixo nível de escolaridade dos agricultores. O presente estudo tem como objetivo analisar o processo de comunicação de riscos relacionado aos agrotóxicos no trabalho rural do Pólo Floricultor de Nova Friburgo/RJ, através de um estudo de recepção de informações, por parte de agricultores, referente aos rótulos e bulas dos principais agrotóxicos utilizados por eles durante o seu processo de trabalho. Através de uma abordagem qualitativa, foram aplicados questionários semi-estruturados a 29 dos 30 produtores de flores locais, avaliando o seu processo de trabalho, seus anseios e o conhecimento acerca das questões que envolvem o uso dos agrotóxicos. A análise dos dados identificou uma série de situações relacionadas com o nível de informações e a sua interpretação pelos trabalhadores; o manejo indevido atribuído ao desconhecimento dos reais riscos que estão expostos é uma delas...

The intensive use of pesticides for crop protection results in impacts on human and environmental health status, particularly when this use is not associated with normative policies and control actions. Major rural workers poisonings can be straight associatedto a number of factors, including difficulties to comprehend the available information. One of many solutions should be a more effective and independent technical assistance,dissociated with commercial interests – a serious situation usually more seen and that can be pointed as one of the main determinants of pesticides use increase in the last few years. In some cases, information access is restricted to labels reading, constituting the only information resource available for a large group of rural workers. This situation is even more serious considering these professionals’ low formal-educational background. The present study aims to analyze pesticides risk communication process in a rural,flower-producer community of Nova Friburgo municipality, Rio de Janeiro State – Brazil, through an information-reception study focusing labels reading. Through a qualitative health research approach, semi-structured questionnaires were applied to 29of the 30 local flower producers aiming to characterize local work processes, workers beliefs and perceptions, as well as to identify their ability to correctly understand pesticides labels information (visual and written). Results showed that this information is not correctly understood by workers, leading to some unsafe work practices such asinappropriate pesticides formulation and use and several exposures situations, as well as the non-adoption of protective gear. These data point the need of a more effective risk communication policy, particularly involving the community...